GASTROESOPHAGEAL REFLUX AND CHRONIC COUGH - WHICH COMES FIRST

We evaluated the relationship between gastroesophageal (GE) reflux and chronic cough using prolonged pH monitoring and the standard acid ref lux study in a retrospective case review. Ten patients were referred t o our clinical esophageal laboratory for prolonged pH monitoring to de termine whether GE reflux was the cause of chronic cough. In addition, we report one patient referred for a standard acid reflux test as a c lear example of spontaneous cough inducing GE reflux. Of the 10 patien ts having prolonged pH monitoring, 182 of 221 (80.9 +/- 4.6%) of cough episodes had no correlation with GE reflux (p = 0.0001). Of those cou gh episodes that appeared to be related to GE reflux, 27 of 39 (69.2 /- 11.7%) occurred before GE reflux and 12/39 (30.8 +/- 10.3%) occurre d after GE reflux (p = 0.06). In the single patient GE reflux after sp ontaneous cough occurred five of seven times during a standard acid re flux test. In our series, cough and reflux were not related in the maj ority of episodes. Where there was a relationship, it appeared that th e cough preceded GE reflux twice as often as reflux preceded cough. We conclude that GE reflux does not appear to be a frequent cause of chr onic cough.